Annual audit has improved outcomes of circumcisions

By: Dr. Khan

Published: June 25, 2025

Annual audit has improved outcomes of circumcisions with disposable rings in children in a community clinic under local anaesthesia – Thornhill clinic and Leyton clinic, London


Purpose

To evaluate the early postoperative complications particularly impaction of disposable devices in children’s circumcision procedures under local anaesthesia in a community clinic in this year’s audit versus previous 3 audits. 

Material and Methods

In our current audit cycle, the outcome of circumcisions (n=1222) was prospectively studied over a 1-year period (May 2017 to April 2018) and were compared with the last 3 audit cycles. Circumcision was performed under local anaesthesia, by trained doctors in a community clinic using Circumplast (CC)(n=310) and Plastibell (PC)(n=912).  Early postoperative complications especially ring impaction were compared among the four audits. Follow-up was arranged if required.

Results

The mean age was 4.4±0.3 months (median 1.5). Complication rate in this year’s audit was 5.1%(62/1222). There is no significant difference in overall complications rate in CC(6.8%n=21/310) versus PC(4.5%n=64/979)(p>0.5). Delayed ring separation/impaction is significantly lower in CC (1% n=3/310) versus PC (2.4% n=22/912) (p<0.05) and has significantly improved from the previous three audits. In current year, 202 (16.5%) children were followed and mean duration was 10±2.6 days (median 6).

Conclusions

The annually conducted audit has shown improved outcomes of circumcisions with disposable rings in children in a community clinic under local anaesthesia over successive years.

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Ref: Accepted as presentation and poster in ESPU 30th Meeting, Lyon, France.

Dr. A.R Khan

Paediatric Surgeon/Urologist

Bio

BSC, MBBS, FRCS, FEBPS, FRCS (PAEDS)
Dr. Khan is a highly experienced and respected paediatric surgeon and urologist with a distinguished career that spans over three decades. He has performed more than 7,000 circumcisions in the UK and is recognised for his expertise in treating foreskin problems, buried penis, and hypospadias. Dr. Khan is also pioneering new techniques in circumcisions for adults, children, and infants, ensuring the highest standards of care for his patients.
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